Developing effective self-care behaviors in college is an important factor affecting undergraduate students' academic achievement and overall adult health outcomes. To address the gap in both research and practice between information literacy and health education targeting undergraduate students, this study explores to what extent undergraduates demonstrate health information literacy (HIL) competency in their health information seeking and use for self-care. It employs Dervin's sense-making... Show moreDeveloping effective self-care behaviors in college is an important factor affecting undergraduate students' academic achievement and overall adult health outcomes. To address the gap in both research and practice between information literacy and health education targeting undergraduate students, this study explores to what extent undergraduates demonstrate health information literacy (HIL) competency in their health information seeking and use for self-care. It employs Dervin's sense-making theory as a framework, which characterizes human information seeking and use as situation-gap-bridge-outcome occurring through different contexts within time and space. A three-phase design for data collection was used: 1) a group-administered survey, 2) a semi-structured interview, and 3) a follow-up observational study of online health information searches using think-aloud protocols. The study results provide a better understanding of how students' HIL competency shapes their health information-seeking behaviors and affects their self-care activities. Given that health information literacy is a multifaceted integrated skill set, contextual factors, such as information environment, health issues, and self-care situations, would not likely change the fundamental skill base that comprises HIL, but these different situations often demand different levels of HIL knowledge and skills. Many students in the study demonstrated insufficient HIL knowledge and skills in some specific contexts of seeking and using health information for self-care. This insufficiency can compromise the extent and usefulness of their health information seeking. Some of them were unaware of their insufficiency based on the inconsistency between their perceived and actual HIL competency as demonstrated in the interview and the observational study. Therefore, the study contributes both theoretical and practical knowledge to the currently limited body of research on undergraduate students' health information-seeking behaviors and health information literacy. Its results present important insights for the future development of more effective college HIL intervention strategies that can help in addressing current or potential student public health issues. Moreover, the results are useful to inform the development of an effective HIL measurement instrument without overemphasizing one or two components of the HIL skill set, such as educational level or computer skills. Show less